Sunday, January 29, 2012

On Life and Making Other Plans

This is the last of a three-part posting about my dance with the love of my life, my wife Kym. You may want to read Part I, Shall We Dance?, then Part II, Romance, Meet Reality, and see Regina Holliday's post on the remarkable Walking Gallery paintings she made for us.

Our Wedding Day - Summer Solstice 2000
John Lennon's famous quote--life is what happens when you're making other plans--aptly describes our experience shortly after we exchanged vows on Kaua'i's Shipwreck Beach as the sun set behind us. We had quickly fallen in love with The Garden Island and had worked out a five-year plan that included the goal of owning homes in Boston and Kaua'i so we could experience the best of both worlds.

That five-year plan lasted about two weeks.

We came home from our honeymoon to the news that Kym's stepfather--a man I never met because Kym was no longer on speaking terms with him--had died that very day.

His funeral was held in Canton, CT (where Kym grew up) just a few days later. It was a very strange and sad event.  Strange because most every conversation we had in the receiving line went something like "I am so sorry for your loss... and congratulations on your marriage!" And sad because there wasn't a single person among the few who attended the service who was sorry to see him go. They dug up a drinking buddy to do the eulogy and the one remotely positive thing he could say of Kym's stepdad was that he was smart.

But, as Kym had already told me, he used his intellectual powers more as a weapon than a force for good. I got to see this firsthand as we sorted through his meager personal effects with Kym's mom and found a pile of editorials--written for no apparent purpose other than his own amusement--that were full of misogynistic sentiments and spiteful words shrouded in clever turns of phrase. We read a sampling before throwing them all in the trash.

The funeral was a painful way to start our marital bliss. As we returned from Connecticut a couple of days later, Kym felt physically and emotionally spent.  Her significant difficulty walking up the stairs to our second-story apartment was inexplicable given her commitment to personal fitness.

Even though she hadn't yet been "late," I thought she should check the box and get a pregnancy test. Two lines. An OB friend loaned me the keys to his office so we could get early ultrasound confirmation of her positive test. The grainy image of a tiny sac left no doubt about the result--or the timing of conception... our wedding night.

Putting all of the pieces together, we ultimately figured out that the Pill had been the culprit causing many of the symptoms that led to Kym's C/T scan... that led to the (incorrect) diagnosis of a recurrence of Hodgkin's Lymphoma... that led to our decision to set a wedding date sooner than later... that led to that magical evening on the beach. The Pill had also thrown off her schedule so she had no idea our wedding night was right in the middle of the baby-making window. Clearly, Kym's radiologic oncologist had succeeded in preserving her fertility.

I had already started down the path of finding a urologist so I could get "snipped" about three weeks after our wedding. Some say our son's conception during that brief window of opportunity was fated; others say it was an act of God's will. Whatever the source, you could make the argument that the vehicle for either option was the Pill--a conclusion made even more ironic by the fact that I was trained as an OB/Gyn.

Understandably, this seminal news left us stunned. The deer-in-headlights sort of stunned. It took us a good bit of soul searching to figure out what to do with this fork in the road. We hadn't looked at each other with the co-parenting lens for longer than it took us to laugh at the absurdity of it. Now we had to look deep into our own hearts and make a decision about something for which neither of us were truly prepared.

In the end, it came down to some simple calculus. We went to a local golf course--Kym had been giving me lessons on one of her greatest passions--and talked through it all while strolling though that idyllic setting. We concluded that, as much as we weren't ready to be parents, having a child could be an incredibly healing and enriching experience for us both. We knew the opportunity to share this particular journey together would almost certainly never come again.

So we chose to accept it as a gift and prepare to take a whole new direction. Gone were my visions of being a "kept man" so I could work on longer-term goals, inventions and creative works. I needed a "daddy" job with health insurance and a steady paycheck.

The pregnancy had its difficulties, with some early tests indicating that all was not well and some emotional challenges for Kym as she struggled to fully embrace motherhood during her pregnancy. All our concerns were assuaged when a very healthy, 10-pound 2-ounce Taylor used his well-developed lungs to let us know he was more than okay and none too happy about his emergence.

Fast forward almost 11 years. Kym and I have had our rough spots. Our marriage has been far from perfect and there have been at least a couple of times when we wondered why we were together at all. Today I can say that Kym and I are both happier than we've ever been--not just since our wedding day, but in our lives. Though I wasn't looking for a "real" job--I've found a meaningful and rewarding career in shaping the future of healthcare in my consulting work. It is demanding, but it still leaves room for family and creative pursuits. Kym has had time to focus on raising Taylor, completing her MBA at UConn, and, in the last several months, finding peace in her new-found Christian faith. And Taylor is thriving--blogging about his inventions, making increasingly impressive videos, and becoming a Black Belt in karate. We both continue to become more whole as individuals--my geek side would say we're asymptotically approaching wholeness--and Taylor has been a profoundly important part of our personal journeys.

What started as a passionate romance has grown into something even more powerful--a family.

Thanks, Regina, for inspiring me to look back at those early years so we could appreciate where we were when we started and how far we've come.

Tuesday, January 24, 2012

Romance, Meet Reality

This is Part II of what will likely be a three-part posting of the story of my dance with the love of my life, my wife Kym.  You may want to read Part I, Shall We Dance?, first and see Regina Holliday's post on the remarkable Walking Gallery paintings she made for us over the weekend.

Regina Holliday's Walking Gallery Painting:
"Knowing the Score"

In December of 1996,  I left Ohio and a very fiscally appealing if not somewhat limiting job as an Obstetrical house physician intent on getting Michael Crichton's job--or at least becoming a recognized screenwriter/novelist/physician like Dr. Crichton.

I packed up a few things in the largest U-Haul trailer my Saab could pull and left for Southern California, where I planned to pedal my screenplays and musicals while supporting my writing habit as a healthcare consultant.  I had a six-month MHA residency set up at PacifiCare of California, a few good connections in Hollywood that I had been fostering for a couple of years, and a belief that I could make it happen if I continued to hone my craft and remained patient.

A friend gave me a card on my departure--on the front, a child-like drawing of a simpleton wearing a goofy smile and dunce cap, carrying a flower, and stepping off of a tall cliff with ravenous wolves positioning themselves beneath for the kill.  The caption read "A Romantic steps out into the world..."

I looked at the card and smiled.  My friend knew me well.  So I said, "Yeah, but you're assuming that the guy in the picture will fall."

Yes, I am a romantic. But I like to think that my romantic notions are not unteathered from reality, but are based on a different way of seeing reality--one that is not so dependent upon conventional wisdom or even the conventions of time and space.  I am generally patient--to become a physician, you have to be well-versed in gratification deferment (even more, the developer of technical standards for health IT).  So to me, even the definitions of success and failure are supremely dependent on the time frame or on how far you pull the lens back.

The story of what happened to me in the Land of Tinsel and Lies is better told another day.  My point in sharing this snippet is to convey my willingness to look past the immediate and keep my eyes on opportunities that may seem improbable but worth the effort.

The story I do want to tell now is about how Kym and I started off as a couple and came to be a family...

On Millennium Eve, I proposed to Kym after knowing her for just six weeks.  There were several reasons why this didn't seem all that rash a decision to me at the time.  We had both been married before, so we had a sense, at least, of what we weren't looking for.  We weren't going to have children, so that was a huge set of considerations we didn't have to consider.  We were in our mid-thirties, so we were grown up enough to be reasonably formed into our long-term selves, having worked through at least a good portion of youthful angst and forethought-less actions.

We also shared one very basic feature that was so important to me that it took precedence over all others: we both--Kym especially--valued personal growth.  Kym had no illusions that she was perfect or that she had life completely figured out, but she was deeply committed to looking inside of herself with those dark, unflinching eyes, taking personal stock of what she saw and didn't like, and doing whatever it took to work it out.

In other ways, we weren't what you would call a perfect match.  I was all about music and magic; Kym, sports and success.  Even in these, we found ways to be interested in one another's worlds and interests.

The one thing that scared me more than a little was what we came to call the psychiatric joke of our relationship:  She had OCD and I had ADD, so she would make rules I could never remember.  Her obsessive-compulsive behaviors probably developed as a response to her experience of growing up in a home with alcoholic parents and getting Hodgkin's at 17.  As a result, she had a serious need to control her environment--especially related to concerns with cleanliness.  I literally had to learn entirely new ways of engaging with the world, our home and Kym in order for us to share space and bodies.

Kym's experience of dealing with my ADD was no picnic either. ADD is a real two-edged sword: it makes it possible for me to connect dots that others can't even see and to create music, catchy lyrics and magical moments; it also creates real problems that can make a mess of the simplest tasks.

When the impact of those omissions just affect me, I can build the losses and delays into the cost of doing business. One of the ways I've learned to cope with my ADD is to spin lots of plates--if I'm distracted by something else I'm supposed to be doing, the net effect is productivity, even though an occasional plate gets neglected long enough that it comes crashing to the ground. If you're just looking at the net effect--the number of plates spinning at once, it looks pretty impressive. But if you happen to be one of the less fortunate plates, it feels like a roller coaster ride of near misses at best and a shattered disaster at worst.

In our relationship, it was easy to interpret some of my forgetfulness, speak-first/process-later words and actions, and mismatched stated versus realized priorities as neglect, passive-aggressive behavior, or overt hostility. Add to this the fact that extreme emotions--from both stress and elation--tend to increase my ADD-ness, and it's not surprising that our first early relationship was strongly impacted by moments that required lots of 'splainin' on my part.

So it was clear that I was going to need to work hard to make changes to my routines and way of thinking in order to make this work. From my perspective, the investment in adjusting my own behavior to share a life with this remarkable woman seemed more than worth it.  She was very successful in her work as a financial software sales executive and had many professional and personal ambitions that meshed well with my own.  I was in the middle of an ambitious start-up project, was writing and consulting--lots of promise but not a lot of immediate gain.  So she kept the lights on while I was swinging for the fences.

Soon after our engagement, Kym moved up to be with me in Boston.  Our small Brookline apartment had everything we needed, including our dining room/office, which had three phone lines and as many computers.  We were just a block uphill from Beacon Avenue and all the bustle (and excellent dining options) of Washington Square, while enjoying the quiet of a well-heeled residential neighborhood.  We had the flexibility to make our own schedule, though our passion for working hard for our goals eventually forced us to set business hours--we declared the dining room/office closed after 6pm, otherwise we would have worked until midnight every night.

We were enjoying our lives and each other.  And while we were in no particular hurry to tie the knot, we knew it would happen eventually, so we didn't much stress about it.

It's part of the punishment of the cancer survivor: you're always waiting for the other shoe to drop, so you have to be diligent about every sign and symptom and "check the box" to be sure it's nothing to worry about.  Kym was the picture of health--she was very careful about the food she ate and how it was prepared, what supplements she took and the kinds of exercise she did.  And she listened to her body.  So when Kym started having night sweats and some other troubling symptoms a couple months after we were engaged, she promptly connected with her oncologist in Connecticut who ordered a C/T scan as a precaution.

The evening she came back from Connecticut, I remember running from our living room to the hall to greet her, doing some silly imitation of Edith Bunker welcoming Archie home.  Kym's jaw was clenched and her eyes sullen.  I can't recall her exact words, but her countenance said more than words could express.

Ever effective in the art of persuasion, Kym had managed to get the radiologist to, against protocol, give her his reading of the film rather than make her wait for it to come from her oncologist.  He said, "I'd prepare for a recurrence if I were you."

Recurrence.  That meant Hodgkin's Lymphoma, which meant chemotherapy.  Kym had already had radiation nearly 20 years before and had had an exploratory laparotomy and splenectomy.  So chemo was an almost certain fate.  And the prognosis for a recurrence was not good.

More than once, someone has told me that they could never see themselves marrying a cancer survivor--it's just too scary.  I never really thought about it that way.  Life is what it is and we don't have guarantees of anything.  How can you know that anyone you marry won't have problems or an accident.  I once met a woman whose husband died in a shark attack while swimming on their honeymoon.  Being "healthy" is no guarantee.

So we put our energies into getting as much information as we could and putting ourselves in the best position for a positive outcome.  "Be prepared for the worst; hope for the best" was something Kym liked saying a lot.   Having just finished my informatics fellowship at Harvard Medical School, I was able to quickly get Kym connected with a doctor who had literally written the book on Hodgkin's at the Dana-Farber Cancer Institute.

After two weeks and around $10,000 worth of tests, including a gallium scan, the verdict was in.  Kym didn't have cancer.  Her symptoms were probably caused by something else and her initial diagnosis was likely the result of an overzealous reading of her C/T scan that really showed nothing more than scar tissue from her prior radiation.  Had the radiologist been able to access her old films, all of the pain and cost of those age-inducing weeks could have been avoided.

We took it all in.  We had dodged a bullet, for sure, but it gave us pause.  Life is short--even a life with a longer-than-average lifespan.  We decided our best response was to say, "Let's make every day matter."  Which for us meant getting married as soon as we could pull it together.

Our wedding took place on Summer Solstice 2000.  At sunset.  On the beach.  In Kaua'i.  It was so beautiful our wedding pictures look fake--like an Olan Mills backdrop that could have been swapped out for library shelves with the pull of a cord.

And then, as we would soon learn, we got pregnant on the same beach about six hours later.

As with the year before, I wrote Kym a Christmas poem a la Seuss, that pretty much sums up in seven stanzas what took me over 1500 words of prose...

Oh, the year we have had! with its jostles and bumps
We’ve been high on the Rooftops! And down in the Dumps
Just when we thought that our future was clear
We’d turn 'round a corner and Change would appear
With his old pal Uncertainty one step behind
All the This-Way-Then-That-Ways became quite a Grind!

Just writing a poem about this year’s events
Creates quite a story that’s rather intense!
We started the year with the Best New Year’s Yet
I popped the question and you said, “You Bet!”
We partied all night at a Y2K ball
And, according to F.J., your gown beat them all!

We moved you to Boston to start a new life
And prepare for the day we’d be Husband and Wife
But our hopes for the future were dashed when we learned
That your Hodgkin’s, so long in remission, returned
For two weeks we viewed your prognosis with terror
When finally we found that the test was in error!

A lesson emerged from that troubling event
Each day must be lived to its fullest extent
We made a decision on that very day
That we should get hitched without further delay!
A few short months later we flew to Hawai’i
And, witnessed by loved ones, were wed on Kaua’i
But wait! That’s not all that occurred on that day!
For that very same night we conceived Taylor Jay!

Talk about Changes! These DINKs 'til their day’s end
Were suddenly thinking of Pampers and Playpens!
And Sippy-Cups! Strollers! Au Pairs and Papooses!
Barneys and Pokémons! Potters and Seusses!
Our image of just you and me quickly faded
We “Saabed” on that fateful day Cloe got traded
But no doubt, this all will be worth all the Fuss
The day we see Taylor’s eyes looking at us

There’s just not the room to depict all our plans
Of Start-Ups that didn’t and Möbius Bands
Of Legal Frustrations and Selling Sensations!
Of New Jobs and Old Saabs and Small Tribulations
And next year – Look Out! We’re just getting started!
We may move from Boston to places uncharted

But one thing remains – be there Change or whatever
My love for you grows every day we’re together
And one other thing remains Certain, my wife –
I still cherish the night you danced into my life

The story (at least this chapter of the story) wraps up in my next post...

Sunday, January 22, 2012

Shall We Dance?

Regina Holliday's Walking Gallery Painting:
"Love is an Ever-Fixed Mark"
The incomparable Regina Holliday is, as I write this post, painting a portrait on one of my wife's jackets as part of her Walking Gallery collection of images depicting patient-centered care issues. She finished my jacket, pictured above, earlier this evening.  It captures her interpretation of the story of how Kym and I met, fell in love, married and became a family.  As with her other Walking Gallery paintings, no doubt Reggie will write in her blog about what it all means -- I recognize most of the imagery, but I'm not yet sure about the cells across the sky or the deeper meaning of the title she gave it: "Love is an Ever-Fixed Mark," but I'm looking forward to reading about it and seeing how Kym's jacket reflects the images painted on my own.

We've talked of doing this for many months and I finally got our jackets to Reggie as our paths crossed (through a helpful hotel concierge) at the 2011 mHealth Summit where she was painting at a booth and I facilitated a session on mobile health standards.  Today she tweeted about needing to fill in some of the details of our story so she could paint.  So I called and shared our story again.  She said she had tried to find the answers on my website and blog and came up short.  "You're such a wonderful writer," she said.  "I wish you would write more."

That made me realize I had never really written out our story, though I've told it many times.  It's a lovely tale worth repeating and today is a perfect day to do it.  Not because of some magic of the day (though Reggie's paintings do provide a wonderful backdrop), but more because it's not been a particularly magical day.  Kym is preparing to return to work after a ten-year hiatus and, in talking about sharing responsibilities and managing the mundane tasks of living life, I confess to being irritable and not particularly pleasant to be around.  Taking the time to reflect on and put fingers to keys to document our early days is a perfect reminder of what is important and how much we have to celebrate.  So let us go back to an evening, November 13th, 1999 in Burlington, Massachusetts...

I was a little over a month away from finishing my fellowship in medical informatics in Boston and had taken up ballroom dancing.  I had always enjoyed dancing and wanted to learn enough to be able to lead on the dance floor--that last bastion of chivalry.  I entered a Fred Astaire competition with my instructor as a novice.  It's a bit of a racket and I've seen people spend thousands of dollars on lessons, costumes and entry fees, but it's also great fun and a way to forget about troubles--like not being able to find the woman of my dreams.

I'd been married once before--to a med school classmate--a marriage that was an extreme roller coaster ride of an experience and not something worth recounting here.  It left me pretty bewildered and defeated, but enough years had passed that I finally felt ready to begin again and not so damaged that I couldn't believe in finding a soulmate.  My aspirations weren't all that outrageous--simple really.  There were only four criteria for my "ideal" partner: East Coast sensibilities, West Coast attitude, and Midwest values in a package that's easy to look at.  Only trouble is I was having a very hard time finding all four of those qualities in a woman--at least one that wanted anything to do with me.

So by the time of my first (and, as it happens, only) ballroom dance competition, I was no longer intently seeking out a soulmate, but had resigned myself to the fact that I may be alone for a good while longer.

The competition was good fun.  I receive first place in all of my dances (where I competed with other novices) and enjoyed watching the showcases and getting to meet other people from other studios.  I also had a show that weekend at a Starbucks in Brookline, so I had brought my guitar to practice that Friday afternoon.  I ended up playing for a woman and her teenage daughter as they took tickets at the hotel ballroom.  Then I drove back to Boston, did my show and came back the next day for my final rounds of competition and the after-party--which is pretty much like a wedding reception except that everyone actually knows how to dance.

During the after-party, I was dancing in a conga line with a truly massive woman who hurried over to join her friends as soon as the song had ended.  This was fine with me because one of those women was someone I had noticed earlier that evening from across the dance floor.  She looked stunning in her black gown, with short dark hair swept back and a long, graceful neck that was poised just so on her dancer's shoulders.  She reminded me more than a little of Audrey Hepburn.

This was, of course, Kym.  She had come to the competition to root on a friend and had just started taking lessons herself.  We were introduced and, after a few minutes of chatting, the other three women made themselves scarce.  The only thing left to do was dance.

Kym had been learning the Latin dances--salsa, rumba, cha-cha--and hadn't really gotten into the smooth dances--the waltz, tango, foxtrot.  So we spent some time in an on-the-fly lesson.  My lead was just strong enough to get us through it, though I recall stepping on her dress once or twice.  I was taken by Kym's grace, powerful presence, her dark brown eyes--"as close to black as brown dare go" as I recall one writer describing a similar pair--and her "regal bearing," which is the way Craig Robinson, the best man at our wedding, described Kym.  I remember that night, as I walked Kym off the dance floor so we could find a quieter place to continue our conversation, commenting that I felt like royalty as I placed her left hand over my right and led her off (the competition was over, but the rules of propriety and etiquette still applied).

That conversation lasted until well after two in the morning.  One of the first things Kym told me was that she was a cancer survivor--she'd been diagnosed with Hodgkin's Lymphoma when she was seventeen--and that being a survivor was the most important experience in her life.  She had also survived a pretty shitty childhood as an only child of two alcoholic parents and had recently ended her second marriage.  She also felt compelled to tell me (not that we were ever going to even date, mind you) that she wasn't going to have children.  I think she figured I must have wanted a half dozen of them because of my past profession as an obstetrician.  But the radiation that took her to within an inch of her life in order to save it had done quite a number on her.  She both doubted that she could have a successful pregnancy and feared that the health risks (melanoma in particular) were too high to risk it.

I was more than fine with that--even with her insistence that she was in no way looking for a relationship.  I actually believed her.  But I also saw that she was everything I was looking for in a partner and was willing to wait it out and see where this could take us.

By the time we parted for the evening, the morning was just a few hours away.  She would be heading back to Connecticut with her friends and I back to Boston.  There was a breakfast in the morning for which neither of us had purchased tickets (see earlier comment on Fred Astaire and racket), but she said her friends were going and she would be down there with them.

The next morning, I get to the breakfast and find the same woman who had been my practice audience on Friday afternoon taking tickets for the meal.  I told her that I didn't want to eat anything; I just wanted to meet someone in there who was expecting me.  She was resolute: no ticket, no entry.  But, come on--you can trust me.  Hadn't I sung you all those wonderful songs just the other day?  No ticket, no entry.  Finally, I was desperate.  "Look," I said.  "The woman of my dreams is in there right now and I really need to see her."  "How can you be sure she's the woman of your dreams?"  "How can I find out if you don't let me in!"

Finally, she relented.  I found Kym (who had had no difficulty getting past the same sentry despite her own ticketless state) and we had a brief conversation, exchanging phone numbers and email addresses.

Phone calls continued most every day from that point, with Kym still insisting that she wasn't looking to get involved with anyone.  I still believed her, but continued to hold hope that things would change in time.

Time went a lot faster than I expected.  Within a couple of weeks, she invited me to come visit in Connecticut so we could go out dancing together at a Latin club.  Then Thanksgiving came around and her plans of sharing the holiday with a friend and her kids fell apart when they all got the flu.  She also learned that weekend that a high school classmate had taken his own life.

So Kym was feeling pretty alone when I called her from Ohio, having just arrived at my parents house to celebrate the holiday.  As we talked, it was my mother who, having overheard some of our conversation, suggested that Kym come have Thanksgiving with us.

This was the clincher for me.  Anyone crazy enough to fly to Ohio on a moment's notice to share a holiday was someone worth spending a life with.  She looked into flights for Thanksgiving morning (a pretty slow day in the midst of an otherwise chaotic travel weekend) and arrived in Dayton about 12 hours after we spoke.

Christmas followed in short order and we shared another magical holiday together.  There was now no doubt that we would share many more holidays and I told Kym that I wanted to marry her in a shop in Harvard Square right around that time.  I also wrote this poem for her, modeled after her favorite Dr. Seuss book, Oh, the Places You'll Go!:
Oh, the places We’ll go! With hopes flying high
We’ll soar through the air! Our limit, the sky!
Except when you fall and Deep Troubles brew
But when life is its darkest I’ll be there for you
And wouldn’t you know it? The opposite’s true!
When I’m in the Pickle you’ll bail me out too!
For life is just Grand! Despite the Rough Parts
And life’s even better when shared as Sweethearts
So here’s to the Journey! And our yet-revealed Fate
I’m honored to walk the unknown as your Mate
And as we go forward as Husband and Wife
I’ll cherish the night you danced into my life
We were officially engaged on Millenium Eve, just six weeks after we first met.  We didn't set a date for a wedding as, having both been married previously, we weren't in any particular rush.  But soon after, she was able to convince her company to let her keep her job as a financial software sales executive (where she was a top performer) and work remotely.  We moved into an apartment just above the one I'd had in Brookline and set up shop.

It is late and there is much more to the story, but it will have to wait for the next post, Romance, Meet Reality.  Stay tuned...